Health Insurance and Healthcare in Austria Explained

How Healthcare Works in Austria

The healthcare system in Austria provides excellent healthcare for the vast majority of citizens. Approximately 99% of people who live in Austria are part of the public healthcare system, but it is also possible to purchase additional private health insurance. “Special Class” or “Comfort Class” private healthcare offers you certain benefits, such as shorter waiting times, access to exclusive physicians not available through public healthcare, private hospital rooms, and even a private bathroom or guaranteed television in your room. Read on to see the Austrian healthcare system explained.

How Does Healthcare Work in Austria?

Around 99% of residents in Austria are covered by some form of health insurance. Becoming a part of Austria’s public health system is very straightforward: as soon as you start a job in Austria your employer is obligated to register you with Social Insurance within seven days of your start date.

What Does the Public Healthcare Cover?

Austria’s public healthcare system is comprehensive, covering virtually all your health care needs, no matter your age or background.

The Features of Public Healthcare

• Employed people contribute to the public healthcare system through their salaries.
• Everyone who is covered by public health insurance gets an e-card.
• It is then possible to receive medical services without advanced payment by presenting this e-card to medical professionals.
• People are covered through four pathways: precautionary, maternity, therapeutic aids, and illness.
  • Precautionary includes things like vaccinations, remedies and treatment, lifestyle advice, health checks, health at work, and recovery.
  • Maternity encompasses childbirth and things like parental leave benefits, child allowance, and maternity allowance.
  • Illness includes work-related illness, doctor visits, mental illness treatments, and support with serious health problems.
  • Therapeutic aids are for the incapacity for work, accidents at work, treatment after accidents at work, and occupational diseases.
• E-cards contain a photograph of the owner and can even be used for electronic signatures.

Does Austria Have Free Healthcare?

Healthcare in Austria is only free for those who are pensioners, spouses of workers, out of work and on unemployment benefits, and people who are unable to work for other extenuating reasons. If you work in Austria, you contribute to the public healthcare system through your salary, which is taken out of every pay check as a health insurance tax.

Austria Health Care Facts

• Public healthcare is available to all Austrian citizens and also EU/EEA citizens.
• Students from EU/EEA countries can use the European Health Insurance Card to access healthcare in Austria.
• Self-insured students based in Austria must pay around 50 EUR (60 USD) per month for national health insurance.
• You do not usually need to do anything to register for the public healthcare system. Once you are employed, you will be automatically enrolled.
• Spouses and underage dependents of employed individuals who are registered to the public healthcare system are called “co-insured” persons and they are also covered.
• Health insurance is guaranteed to pensioners, students, the disabled, and anyone receiving unemployment benefits.
• Enrolment to the public healthcare system is not optional.
• It is up to employers to register their employees with public health insurance. They then take the health insurance tax from the employee’s salary and pay it to the state.
• Self-employed workers are not automatically added to the public health system, but they are allowed to register.
• The amount paid towards public health insurance is based on a worker’s salary, not their health conditions.
• Self-employed people are covered under the Act on Social Insurance for the Self-Employed (GSVG).

Austria Health Care Costs

Public spending on healthcare in Austria was about 22 billion EUR (30.3 billion USD) in 2011, which is about 7% of GDP (gross domestic product) and 25% of social expenditure. Some 81% of this 22 billion EUR sum paid for outpatient and inpatient care. And a significant 15% went towards income support for employers, due to people missing work or because of illness.

Costs to the General Public

• For most health services, employed people and farmers are likely to benefit for free from the moment they begin receiving care.
• For outpatient visits, you may have to pay between 10 and 20% of the overall cost for contracted physicians.
• Since 2006, there has been a cap on payments for civil servants. In 2013, a cap was introduced for self-employed workers that limited charges for outpatient visits to 5% of their net annual income.
• For medical aids, such as wheelchairs, most people are covered for up to 1,328 EUR (1,465 USD) per aid.
• Cover for therapeutic appliances, such as electric wheelchairs, varies between provinces in Austria. Regional funds in Vienna and Tyrol cover only up to 498 EUR (550 USD) while funds in Lower Austria, Upper Austria, and Salzburg cover up to 3,320 EUR (3,663 USD).
• Prescriptions cost a little less than 6 EUR (7 USD) per item for medicine on the “positive list.”
• People receiving the minimum pension, conscientious objectors choosing an alternative civilian service, people with notifiable communicable diseases, and asylum seekers are automatically exempt from paying prescription fees.
• Employees pay an annual fee of about 11 EUR (12 USD) for their e-card which allows them outpatient visits at no extra charge.
• Self-employed people pay between 10 and 20% of the tariff for outpatient visits. It is only 10% if they reach five personal health goals relating to issues such as blood pressure, weight, exercise, tobacco, and alcohol.

Austria Healthcare System Pros and Cons

Pros

• Almost everyone is covered by the public healthcare system.
• Healthcare is of a generally excellent standard.
• Prescription costs are relatively low for medicine on the “positive list.”
• Family members and spouses of employed people are covered.
• Patient co-payments for hospital stays were abolished in 2017.
• No EU country offers more mandatory maternity leave before the birth at 100% payment than Austria.

Cons

• Some of the best physicians are only available if you have private medical insurance.
• There are longer waiting times with public health insurance.
• Hospital rooms can be shared by up to eight or nine patients.
• New mothers who are employed only receive their full salary for the eight weeks before and eight weeks after the birth of their child. This is not the shortest length for mandatory maternity leave in Europe, but it is not the best either. The highlight is that you get eight weeks before the birth, which is rather generous compared to most other European Union states.

An Overview of Private Health Insurance

The way private health insurance works in Austria is quite simple and similar to the system in countries, like Germany. Whether you already have public health insurance in Austria and you simply want to complement it, or if you are not covered by the public health insurance for whatever reason, you can invest in a form of private health insurance in Austria. However, it is worth noting that only a small fraction of the population utilize private insurance.

Private Health Insurance Coverage

Private health insurance in Austria offers optimal expert care, the ability to choose which physician sees you for outpatient treatment, and life-long coverage. In Austria, a contract with a private health insurance provider is seen as a life-long contractual relationship, which means they cannot come with restrictions and the providers cannot terminate them.

Types of Health Insurance Plans

Inpatient treatment

If you take out private health insurance in Austria and you need to spend time in a special ward at a hospital, the costs for staying there are covered by your insurance. The private health insurer will pay the hospital directly, so you do not need to worry about it.

“Special Class” private health insurance in Austria means you are able to choose your physician and you will have shorter waiting times for operations. In addition, you will have greater choices of doctors who are not available through the public health system. Special Class insurance also allows you to stay in private hospitals, or in private wards/rooms. In these private accommodations you will often benefit not just from privacy (or, at most, one roommate) and more individualized care, but you will also have access to internet, a private bathroom and shower, and other bonus equipment.

Outpatient Treatment

Some private insurance packages include inpatient treatment, or you may need to pay for it separately. Outpatient treatment gives you access to care from a number of physicians who are not available with public health insurance. In Austria, these tend to be some of the more talented and experienced experts. Surgeries with private healthcare doctors and the prescriptions they give are only covered by private health insurance packages.

With private health insurance you will also experience shorter waiting times for the physician of your choice. You will be covered for medication and other medical products, and have access to glasses, contact lenses, and more, all for no extra charge.

More Features

If you get private health insurance in Austria you can also benefit from extra perks, such as free dental care, travel insurance, subsidized gym memberships, and a range of physicals and check-ups.

Do You Need Private Health Insurance in Austria?

With the Social Insurance system so comprehensive in Austria and so easy to access, you only really need to register for additional private health insurance if you want the “Special Class” features or if you suffer from a chronic or serious illness.

How Much is Private Health Insurance?

The average cost of private health insurance in Austria is approximately 220 EUR (243 USD) per month. However, prices vary considerably depending on factors such as age and the features included in each health insurance plan.

How to Get Private Health Insurance in Austria

To purchase additional private health insurance, simply choose a plan that suits your needs. See below for example coverage in Austria.

Private Medical Insurance Example

Private health insurance companies in Austria usually offer several different plans that cater to people of all different ages, with different prices for children under 18 years old up to those 65 years old and over. The older you are, the more you must pay.

For example, a plan for children under 18 can cost around 30 EUR per month (35 USD), while the same plan for people 65 years old and older can cost about 450 to 500 EUR (500 to 555 USD).

Basic Private Insurance Plan Example

• Up to six months of gym memberships or free 5-star hotel accommodation (up to 4 days), and much more, available from the start of your insurance plan and then once every two years
• Cover in Europe in public hospitals
• Worldwide cover in private hospitals while travelling up to four weeks up to 150,000 EUR (165,500 USD)
• Worldwide cover for out-patient treatment while travelling up to four weeks up to 15,000 EUR (16,550 USD)
• Treatments in specialized hospitals worldwide if treatment is not possible in Austria
• Emergency transport to Austria
• High-tech check-up once a year
• Second opinion
• Change to a higher insurance plan without new health questions
• Special class in-patient treatment in private hospitals and public hospitals
• Cover in case of accidents, in case of illness, surgery, and medically prescribed cosmetic surgery
• Maternity cover
• A shared hospital room (maximum two beds)
• No deductible in case of accidents or maternity
• 0 EUR deductible in case of illness for 4 days
• Out-patient surgery

Premium Private Insurance Plan Example

A typical premium plan includes the same benefits as the basic plan, plus:

• Private hospital room
• 0 EUR deductible in case of illness
• Private out-patient medical treatment
• 11,706 EUR (12,916 USD) per year in cover
• 587 EUR (648 USD) sublimit for medically prescribed adjuvants
• 587 EUR (648 USD) sublimit for medically prescribed medicines
• 587 EUR (648 USD) sublimit for medically prescribed physical therapy, midwives, alternative medicine, and massages

How to Find a Doctor or Dentist

In this section, we will explain how to find a doctor and dentist in Austria. During this process, one of the most important things to be aware of is that as long as you are part of the public healthcare system, you can generally see a doctor for free. Plus, dental care is heavily subsidized if you are employed, self-employed, a civil servant, or a farmer.

Remember to take your health insurance card (known as a Krankenschein) with you when you see a doctor, dentist, or a specialist. This will help you avoid paying fees for the meeting. As long as you are insured, you will only have to pay about 4 EUR (5 USD) to see someone. In some areas of the country you will need a voucher for an appointment. If you do, be aware that you may only be allowed a certain number of vouchers (and appointments) per year.

How To Find A Family Doctor

As soon as you move to Austria, or even before you arrive, you should think about registering with a doctor. There is a handy search tool to find a doctor in your area. You can even set parameters like “expertise,” “gender,” and “foreign language.”

Unless you have private health insurance that includes treatment and diagnoses, etc., by a doctor, make sure when you are looking for a new doctor that they are part of the public system. Doctors who accept public healthcare payments usually display a sign saying, Kassenarzt or Alle Kassen in their surgery. If you receive treatment from private doctors, without this sign, and make a payment, you might find you will not be reimbursed for your treatment.

You should make an appointment (known as a Termin in Austria) before going to see a doctor in the public system to avoid a long wait. If you need to go to the doctor urgently, you can still be seen, however, expect to have to wait. Even when you have an appointment, you cannot assume you will be seen by a doctor as soon as you arrive at the doctor’s surgery.

Average Wait Time to See a Doctor in Austria

Research shows that waiting times for doctor appointments in Austria vary from province to province. For example, the average wait time in Vienna is the lowest at 9.1 minutes, in Burgenland it is 10.8 minutes, and in Salzburg it is 12.2 minutes. Carinthia and Vorarlberg have the longest wait times at 17.3 minutes. Other provinces have wait times somewhere in between.

How to Find a Dentist

The convenient Austrian Dentistry Chamber website allows you to search for a dentist in your area no matter where you live in the country. You can search by province and district to find the perfect professional for you.

How to Find Specialists

If you believe you might need to see a specialist, you should first see a general practitioner in your area. If, once they have seen you, they think you need further expert advice or treatment, they will refer you to a specialist. You can make an appointment with a specific specialist if you would like, however, this sometimes requires a referral from a GP.

For a range of doctors and specialists, you can use the Vienna Medical Association’s doctor search tool. If you prefer an English-speaking doctor, you can search for them in the United States Embassy’s comprehensive list.

How to find a doctor or dentist